Hepatitis C virus infection among people who inject drugs in Bangkok, Thailand, 2005–2010

Details

• Alternative Title:
  WHO South East Asia J Public Health
• Personal Author:
  Martin, Michael ; Vanichseni, Suphak ; Leelawiwat, Wanna ; Anekvorapong, Rapeepan ; Raengsakulrach, Boonyos ; Cherdtrakulkiat, Thitima ; Sangkum, Udomsak ; Mock, Philip A ; Leethochawalit, Manoj ; Chiamwongpaet, Sithisat ; McNicholl, Janet M ; Kittimunkong, Somyot ; Curlin, Marcel E ; Choopanya, Kachit
• Corporate Authors:
  Bangkok Tenofovir Study Group
• Description:
  Background
  
  Approximately 1% of adults in Thailand are infected with hepatitis C virus (HCV). New direct-acting antiviral agents achieve sustained virologic responses in >95% of HCV-infected patients and are becoming available in countries around the world. To prepare for new HCV treatment options in Thailand, this study characterized HCV infections among people who inject drugs (PWID) in Bangkok.
  
  Methods
  
  The Bangkok Tenofovir Study (BTS) was a pre-exposure prophylaxis trial conducted among PWID, 2005–2013. Blood specimens were randomly selected from PWID screened for the BTS, to test for anti-HCV antibody and HCV RNA. The HVR1 region was amplified by polymerase chain reaction, using multiplex primer sets with unique identifier sequences; amplification products were pooled in sets of 25; and consensus sequencing was performed to characterize individual HCV genotypes.
  
  Results
  
  The median age of 3679 participants tested for anti-HCV antibody was 31 years, 3016 (82.0%) were male and 447 (12.2%) were HIV infected. The prevalence of anti-HCV antibody was 44.3%. The adjusted odds of testing positive for anti-HCV antibody were higher in men (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI] 2.4–4.3), those aged 40 years or older (aOR 2.7, 95% CI 2.1–3.5), those who had more than a primary school education (aOR 1.7, 95% CI 1.4–2.1), and those who tested HIV positive (aOR 5.2, 95% CI 3.7–7.4). HCV RNA was detected in 644 (81.3%) of the 792 anti-HCV antibody-positive specimens, yielding an HCV RNA-positive prevalence of 36.0% (95% CI 33.8–38.2). Among a random sample of 249 of the 644 specimens, 218 could be characterized, and the most common HCV subtypes were 1a (30.3%), 1b (12.8%), 3a (35.8%), 3b (6.9%) and 6n (8.7%).
  
  Conclusion
  
  The prevalence of anti-HCV antibody among PWID was 44.3% and more than one third (36.0%) were HCV RNA positive. Genotypes 1, 3 and 6 accounted for all typable infections. As the government of Thailand considers introduction of direct-acting antiviral medications for people with hepatitis C, it will be important to ensure that the medications target these subtypes.
  
  
• Subjects:
  Adolescent Adult Antiviral Agents Chi-Square Distribution Female Hepacivirus Hepatitis C Humans Male Middle Aged Substance Abuse, Intravenous Surveys And Questionnaires Tenofovir Thailand

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• Keywords:
  Direct-acting Antivirals Hepatitis C People Who Inject Drugs Viral Hepatitis
• Source:
  WHO South East Asia J Public Health. 8(1):50-55
• Pubmed ID:
  30950431
• Pubmed Central ID:
  PMC7954142
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  8
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:840c86af780aafb1c7ac14474442b972c64e69d422823f21cc98fde07cffe95e
• Download URL:
  https://stacks.cdc.gov/view/cdc/104109/cdc_104109_DS1.pdf
• File Type:
  [PDF - 445.44 KB ]